| NPI | 1578555686 |
|---|---|
| Former Name | PATRICIA L RUSSELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA04420) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2024-08-21 |